Acta Oncologica最新文献

{"title":"Disparities in initiating standard first-line cancer treatment and survival for patients with an immigrant background: a Danish register-based cohort study.","authors":"Emma N Ishøy, Maria Kristiansen, Ismail Gögenur, Erik Jakobsen, Lars Lund, Fie Stegenborg, Susanne Rosthøj, Mia K Grand, Pernille Bidstrup, Morten Sodemann, Susanne O Dalton","doi":"10.2340/1651-226X.2026.46256","DOIUrl":"10.2340/1651-226X.2026.46256","url":null,"abstract":"<p><strong>Background and purpose: </strong>Individuals with an immigrant background may face barriers to healthcare. However, evidence on differences in cancer treatment and survival between patients with an immigrant background and patients of Danish origin is limited.</p><p><strong>Patients and methods: </strong>We included patients aged ≥50 years diagnosed with a first primary colon, lung, prostate, or kidney cancer between 2011 and 2022 from national clinical cancer databases. First-line treatment initiation (30/90 days) and survival (1/5 years) were assessed using risk ratios (RRs) comparing patients with an immigrant background to those of Danish origin. Immigrant backgrounds were categorized according to their origin in (1) other Western countries, (2) Central and Eastern Europe, and (3) the Middle East, North Africa, and Central Asia.</p><p><strong>Results: </strong>Overall, there were no systematic differences in the initiation of first-line treatment or survival between patients with an immigrant background and patients of Danish origin. Exceptions included lower probability of initiating treatment (30-day RR: 0.76 [95% confidence interval (CI): 0.62; 0.93] and 90-day RR: 0.92 [95% CI: 0.87; 0.98]) and 1-year risk of death (RR: 0.85 [95% CI: 0.77; 0.93]) among lung cancer patients from Central and Eastern Europe, lower 30-day treatment initiation among patients from the Middle East, North Africa, and Central Asia (RR: 0.80 [95% CI: 0.64; 1.00]), and higher 5-year risk of death among prostate cancer patients from other Western countries (RR: 1.16 [95% CI: 1.01; 1.34]).</p><p><strong>Interpretation: </strong>Overall, patients with an immigrant background had similar initiation of first-line cancer treatment and survival to those of Danish origin, with some statistically significant differences but no consistent pattern across cancer types or regions of origin.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"766-775"},"PeriodicalIF":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue 5 years after treatment for rectal cancer – results from the QoLiRECT study","authors":"Johan Ekstrand, Rode Grönkvist, Carolina Ehrencrona, Elisabeth Gonzalez, Jacob Rosenberg, Eva Haglind, Eva Angenete","doi":"10.2340/1651-226X.2026.46460","DOIUrl":"10.2340/1651-226X.2026.46460","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fatigue affects colorectal cancer survivors and has a significant impact on overall quality of life (QoL) and possibly overall survival. Fatigue, with focus on patients with rectal cancer, is less studied. The aim of this study was to investigate fatigue prevalence at 5 years after rectal cancer surgery.</p><p><strong>Patient/material and methods: </strong>Data were collected from the Quality of Life in RECTal cancer study, a prospective longitudinal multicenter study of patients with rectal cancer, also using data from Swedish and Danish colorectal cancer registries. Baseline characteristics and treatment-related factors were investigated as potential predictors for fatigue measured with the Piper Fatigue Scale (PFS). Patients were included at diagnosis and answered questionnaires at baseline and at 5 years after diagnosis.</p><p><strong>Results: </strong>The cohort consisted of 1024 patients who underwent surgery for rectal cancer. Five hundred and ninety three patients responded to the 5-year follow-up questionnaire. At 5 years, 52.4% of patients experienced fatigue. Moderate-severe fatigue (PFS ≥ 4) was reported by 172 patients (29%). Higher Body mass index (BMI) at baseline was associated with PFS ≥ 4 (Odds ratio [OR] 1.07, 95% Confidence interval [CI] 1.02–1.11, p = 0.004) in the univariate analysis, with similar results in multivariate analysis. A significant association was found between pain and moderate-to-severe fatigue in univariate analysis, OR 4.34 (p < 0.0001, 95% CI 2.91–6.49), but not in multivariate analysis, 2.8 (p < 0.0001, 95% CI 1.79–4.58). Higher QoL was negatively correlated with PFS ≥ 4 in both uni- and multivariate analyses (OR 0.37, 95% CI 0.30–0.46, p < 0.0001; OR 0.34, 95% CI 0.27–0.44 p < 0.0001). Major low-anterior resection syndrome (OR 2.17, 95% CI 1.09–4.34, p = 0.028) and permanent stoma (OR 1.92, 95% CI 1.06–3.47, p = 0.032) were associated with PFS ≥ 4 in the univariate, but not in the multivariate, analysis.</p><p><strong>Interpretation: </strong>Moderate-severe fatigue is prevalent in rectal cancer survivors. Targeted prevention of fatigue might be of interest in long-term rehabilitation of rectal cancer survivors.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"758-765"},"PeriodicalIF":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CancerWatch: accelerating Europe's cancer intelligence.","authors":"Claudine Backes, Max Xhauflair, Gijs Geleijnse, Maria Dolores Chirlaque, Manola Bettio, Mario Šekerija, Liesbet Van Eycken, Matthijs Sloep, Esteve Rodon Navarro, Dafina Petrova, Yasmin Cura, Maria-José Sánchez, Giske Ursin","doi":"10.2340/1651-226X.2026.46506","DOIUrl":"10.2340/1651-226X.2026.46506","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"743-748"},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between CAR T-cell persistence and improved response to salvage radiotherapy in patients with DLBCL.","authors":"Jiaqi Fan, Nadine Kutsch, Jan-Michel Heger, Philipp Gödel, Eva Heger, Henning Gruell, Philipp Linde, Simone Ferdinandus, Johannes Rosenbrock, Hendrik Dapper, Emmanouil Fokas, Peter Borchmann, Christian Baues","doi":"10.2340/1651-226X.2026.46287","DOIUrl":"10.2340/1651-226X.2026.46287","url":null,"abstract":"<p><strong>Background and purpose: </strong>While Chimeric antigen receptor (CAR) T-cell therapy has transformed treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL), over half of patients relapse within 1 year with poor prognosis. Salvage radiotherapy (sRT) achieves high local response rates, but which subgroups benefit most and whether CAR T-cell persistence influences sRT response remains unclear. Patient/material and methods: We retrospectively analyzed DLBCL patients receiving sRT after CAR T-cell therapy at our center. CAR transgene levels were quantified by quantitative polymerase chain reaction (qPCR), and associations between CAR T-cell kinetics at relapse, sRT response, and survival were evaluated.</p><p><strong>Results: </strong>CAR transgene data were available for 13 patients, (18 lesions treated with sRT). Toxicity was mild (grade ≤ 2). The local response rate was 83% (15/18 lesions). Three CAR transgene kinetic patterns were identified at relapse: increased-CAR (second increase in transgene levels, n = 4), persisted-CAR (persistence > 6 months, n = 4), and decreased-CAR (decline or absence, n = 5). Local response rates were 100% in both the increased- and persisted-CAR groups versus 57% (4/7 lesions) in the decreased-CAR group, 12-month local control rates were 83, 100, and 14%, respectively. Twelve-month overall survival was 100% in both increased-CAR and persisted-CAR groups versus 20% in the decreased-CAR group.</p><p><strong>Interpretation: </strong>sRT may provide durable local control in relapsed DLBCL after CAR T-cell therapy. Persistent CAR T-cell activity at relapse may help identify patients most likely to benefit from comprehensive sRT. Given the small, heterogeneous cohort, these findings are hypothesis-generating and require validation in larger series.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"749-757"},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative circulating tumour DNA in high-risk primary cutaneous melanoma: prospective feasibility in molecular pathology.","authors":"Magnús Pétur Bjarnason Obinah, Estrid Høgdall, Tim Svenstrup Poulsen, Karin Dreisig, Thomas Litman, Christoffer Johansen, Stig Egil Bojesen, Lisbet Rosenkrantz Hölmich","doi":"10.2340/1651-226X.2026.45921","DOIUrl":"10.2340/1651-226X.2026.45921","url":null,"abstract":"<p><strong>Background and purpose: </strong>Circulating tumour DNA (ctDNA) has emerged as a prognostic biomarker in melanoma, but its detectability in pre-operative blood from patients presenting with primary cutaneous melanoma remains incompletely evaluated. We assessed the feasibility of pre-operative ctDNA detection in high-risk primary melanoma using routinely available methods in molecular pathology.</p><p><strong>Patients/material and methods: </strong>In a prospective single-institution cohort enrolled between September 2021 and December 2022, pre-operative plasma was obtained from patients with clinically suspected primary cutaneous melanoma. Patients with pathologically confirmed invasive melanoma and high-risk features (≥ T3a, ≥ N1a, or ≥ M1a) were selected for molecular analysis. Tumour tissue was analysed using next-generation sequencing (NGS) to identify targetable BRAF or NRAS driver mutations, and pre-operative plasma was analysed for ctDNA using droplet digital PCR (ddPCR) for BRAF V600E or targeted NGS for other driver mutations.</p><p><strong>Results: </strong>Of the 288 consented patients with pre-operative blood samples, 21 met high-risk criteria, and 12 had a targetable BRAF or NRAS driver mutation in tumour tissue and underwent tumour-informed plasma ctDNA analysis. Pre-operative ctDNA was not detected in any of these 12 patients (0 of 12; 95% confidence interval [CI] 0 to 26.5%). All ddPCR and NGS assay controls performed as expected, and wild-type copy counts were consistent across ddPCR samples.</p><p><strong>Interpretation: </strong>The finding is concordant with two independent studies using different methods, and a mathematical prediction of ctDNA shedding from small primary tumours. Reliable pre-operative ctDNA detection in primary melanoma may require alternative cell-free DNA (cfDNA) approaches, such as bespoke multivariant or mutation-agnostic methods.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"737-742"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune-checkpoint inhibitor-induced bullous pemphigoid in patients with metastatic renal cell carcinoma: two case reports and systematic review of the literature.","authors":"Panagiotis Filis, Magnus Lindskog, Philip Curman, Natalia Kuzmina, Åsa Krantz, Katerina Chatzidionysiou, Fernanda Costa Svedman, Ioannis Zerdes","doi":"10.2340/1651-226X.2026.46088","DOIUrl":"10.2340/1651-226X.2026.46088","url":null,"abstract":"<p><strong>Background and purpose: </strong>Immune-checkpoint inhibitors (ICIs) improve outcomes in renal cell carcinoma (RCC) but may cause immune-related adverse events (irAEs), including cutaneous toxicity. Bullous pemphigoid (BP) is a rare but clinically significant irAE that can require ICI discontinuation. Patient/material and methods: We report two cases of BP in patients with metastatic RCC treated with ICIs at Karolinska University Hospital, Stockholm, Sweden. In addition, a systematic review was conducted in Medline, Embase, Cochrane Library, and Web of Science to identify published cases of ICI-associated BP in metastatic RCC. Data on patient characteristics, treatment, clinical presentation, diagnostics, management, and outcomes were extracted and descriptively analysed.</p><p><strong>Results: </strong>Twenty-eight publications describing 30 cases were identified. Median age at BP onset was 69 years (interquartile range [IQR] 65-73), and 86.7% were male. Nivolumab was the most commonly reported ICI monotherapy. Median time from ICI initiation to BP onset was 35 weeks (IQR 16-76). Typical manifestations included tense bullae and vesiculobullous eruptions on the trunk and extremities. Diagnosis was confirmed by skin biopsy and immunological testing in 80% of cases. Management mainly involved corticosteroids, while ICI interruption or discontinuation was required in over half the cases. Both patients from our center improved after immunosuppressive treatment.</p><p><strong>Interpretation: </strong>ICI-associated BP is a rare but important irAE in metastatic RCC, often occurring after prolonged ICI exposure and potentially requiring treatment modification. Early recognition may improve multidisciplinary management.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"730-736"},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreter use in Nordic paediatric oncology care - a multicentre cross-sectional study.","authors":"Melissa Jakobsson, Helena Ventovaara, Eva Broström, Pernilla Pergert, Elisabet Tiselius, Johanna Granhagen Jungner","doi":"10.2340/1651-226X.2026.46078","DOIUrl":"10.2340/1651-226X.2026.46078","url":null,"abstract":"<p><strong>Background and purpose: </strong>Tailored, language-appropriate information is fundamental for children and their families in paediatric oncology, influencing both the quality of care and clinical outcomes. Yet, for families who speak another language, interpreter services are not used to the extent necessary to ensure equitable and patient-safe communication. Knowledge about how healthcare professionals (HCPs) (registered nurses [RNs] and medical doctors [MDs]) experience and manage interpreter use is limited. To address this gap, this study aimed to explore the obstacles to interpreter use in Nordic paediatric oncology care and to examine the challenges HCPs experience during interpreter‑mediated conversations. Participants/materials and methods: A cross-sectional multicentre survey study involving 453 RNs and MDs from 20 paediatric oncology centres across the Nordic region. The Communication over Language Barriers Questionnaire was used in each country's majority language. Descriptive and non-parametric analyses were used to summarise and compare the data between countries and professions. Group differences were tested using Pearson's chi-square or Fisher-Freeman-Halton exact tests, with p < 0.05 considered significant.</p><p><strong>Results: </strong>Time constraints in acute but also in planned care situations were identified as the most common obstacles to interpreter use. In addition, when using interpreters, the respondents sometimes or often experienced challenges such as uncertainty about the accuracy of the interpretation and about patients' understanding of the given information.</p><p><strong>Interpretation: </strong>To ensure equitable, safe, and person‑centred care for children and their families, there is an emergent need for improved communication strategies and a need for better organisational support, easier interpreter access, and stronger systems for quality-assured interpreter services across the Nordic region.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"721-729"},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerability and adherence to adjuvant abemaciclib in hormone receptor-positive, HER2-negative, node-positive high-risk early breast cancer: a real-world study.","authors":"Carl Rosander, Karolina Larsson, Per Karlsson","doi":"10.2340/1651-226X.2026.45961","DOIUrl":"10.2340/1651-226X.2026.45961","url":null,"abstract":"<p><strong>Background and purpose: </strong>Abemaciclib in addition to adjuvant endocrine therapy for hormone receptor positive (HR+) breast cancer improves disease free survival (IDFS) and overall survival (OS). However, treatment-related adverse events may lead to early discontinuation. Sahlgrenska University Hospital implemented a gradual increase in initial dosing, with the intention to improve tolerability and adherence. Patient/material and methods: This retrospective observational study described adherence, tolerability and healthcare utilization associated with a gradual dose increase of adjuvant abemaciclib. A total of 69 patients aged 31-81 years were treated at Sahlgrenska University Hospital between 1st of April 2023 and 1st of April 2025 with cut-off September 5th, 2025. Clinical encounters and treatment outcomes were extracted from medical records and analyzed using descriptive statistics.</p><p><strong>Results: </strong>Patients were older and had worse Eastern Cooperative Oncology Group status compared with the monarchE registrational trial. At 12 and 26 weeks, 34 patients (49%) and 25 patients (36%) remained on the full dose of abemaciclib, respectively. Overall, 65 patients (94.2%) and 58 patients (84%) remained on treatment at any dose at 12 and 26 weeks. Treatment discontinuation was mainly driven by low grade adverse events (grade 1-2). During the study period 1069 clinical encounters were recorded; 15 patients (22%) had at least one emergency care encounter and seven (10%) required hospital admission.</p><p><strong>Interpretation: </strong>The gradual dose increase strategy resulted in fewer patients maintaining the full dose at 12 weeks compared with monarchE and TRADE trials, while overall treatment persistence remained high. Treatment discontinuation was primarily driven by cumulative low-grade toxicity and healthcare utilization was considerable.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"713-720"},"PeriodicalIF":2.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of isolated tumor cells and nodal tumor burden in endometrial cancer: a population-based cohort study.","authors":"Andrei Chilianu, Charlotta Riese, Mahmood Ul Hassan, Jaiteh Darbo, Henrik Falconer, Linda Eriksson, Sahar Salehi","doi":"10.2340/1651-226X.2026.45813","DOIUrl":"10.2340/1651-226X.2026.45813","url":null,"abstract":"<p><strong>Background and purpose: </strong>Since the introduction of sentinel lymph node biopsy, nodal assessment has expanded to nearly all women with endometrial cancer. However, evidence on the prognostic significance of isolated tumor cells (ITCs) and nodal tumor burden remains limited. We therefore investigated the association of ITCs and nodal tumor burden with survival.</p><p><strong>Patients and methods: </strong>This cohort study included women with endometrial cancer who underwent surgery in Region Stockholm-Gotland, Sweden, between 2010 and 2024, and either underwent sentinel lymph node biopsy or were registered as having lymph node metastases (FIGO stage IIIC). Nodal dissemination was categorized as bulky, macro-, micro-metastases, or ITCs. Overall survival (OS) and cancer-specific survival (CSS) were evaluated using multivariable Cox regression in two separate analyses: (1) ITCs versus node-negative patients and (2) nodal tumor burden (bulky, macro-, micro-metastases) among node-positive patients.</p><p><strong>Results: </strong>Among 1219 patients, 310 (25%) had nodal dissemination, including 250 with nodal metastases and 60 with ITCs. No significant difference in OS was observed between patients with ITCs and node-negative patients (Hazard ratio [HR] 1.94, 95% confidence interval [CI] 0.75-5.06). Adjuvant therapy was more frequent among patients with ITCs (47% vs. 11%). In patients with nodal metastases, no clear OS differences were observed by nodal burden. Compared with micrometastases, survival was similar for macrometastases (HR 0.95, 95% CI 0.50-1.81) and bulky metastases (HR 1.19, 95% CI 0.64-2.21). Age > 68 years and p53 mutation were associated with worse survival. CSS analyses yielded similar findings, with no significant differences observed in either comparison.</p><p><strong>Interpretation: </strong>Neither ITCs nor greater nodal burden was clearly associated with survival after adjustment for clinical and molecular factors. Survival appeared to be influenced by patient and tumor characteristics, although estimates were imprecise and modest associations cannot be excluded.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"702-712"},"PeriodicalIF":2.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving cervical cancer screening uptake through theory-informed education: a comprehensive systematic review and meta-analysis.","authors":"Huiying Qin, Nana Yang, Qianqian Wang, Lu Tian, Huan Wang, Mingming Ma, Chunfang Chen","doi":"10.2340/1651-226X.2026.45119","DOIUrl":"10.2340/1651-226X.2026.45119","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study examined whether theory-based education increases cervical cancer screening among underserved women.</p><p><strong>Methods: </strong>Seven databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, and PsycINFO) were systematically searched for studies published between January 2005 and November 2025. A total of 1,200 records were identified; after duplicate removal, 900 titles and abstracts were screened, and 200 full-text articles were assessed. Fourteen studies met inclusion criteria for qualitative synthesis, and 12 trials contributed extractable binary outcome data for meta-analysis, including one study with two distinct intervention arms. The primary outcome was screening uptake (Pap smear, visual inspection with acetic acid [VIA], or human papillomavirus [HPV] testing). Data extraction and quality appraisal followed PRISMA 2020 and Joanna Briggs Institute guidance. Pooled odds ratios (ORs) were calculated using DerSimonian-Laird random-effects models with Hartung-Knapp adjustment, and heterogeneity, prediction intervals, small-study effects, and certainty of evidence (GRADE) were evaluated.</p><p><strong>Results: </strong>Structured educational interventions significantly increased screening uptake compared with usual care or minimal information (OR = 4.41; 95% confidence interval [CI]: 2.21-8.80). Subgroup analyses showed substantial effects in both high-income (OR = 3.46; 95% CI: 1.43-8.36) and middle-income settings (OR = 6.55; 95% CI: 2.74-15.63). Interventions frequently incorporated behavioral frameworks, such as the Health Belief Model, Protection Motivation Theory, and BASNEF model, and were often culturally tailored or delivered through community-embedded formats.</p><p><strong>Interpretation: </strong>Integrating such interventions into national and local screening programs represents an effective and equitable strategy to reduce disparities in cervical cancer prevention.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"689-701"},"PeriodicalIF":2.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}